Provider Demographics
NPI:1245801620
Name:ABNEY, ASHLEY LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:ABNEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:2213 100TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-7164
Mailing Address - Country:US
Mailing Address - Phone:432-703-1515
Mailing Address - Fax:
Practice Address - Street 1:605 W 7TH ST
Practice Address - Street 2:
Practice Address - City:POST
Practice Address - State:TX
Practice Address - Zip Code:79356-3141
Practice Address - Country:US
Practice Address - Phone:432-703-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2147047225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant